Stories about the patients, staff and services of UVA

After a heart attack or a car accident, you might recall the hospital nurse you saw almost every day, the doctor who spent so much time explaining your surgery or the physical therapist who pushed you to your limit.

But before any of that happened, there were emergency responders who cared for you at the very beginning and got you to the hospital.

May 19-25 is National Emergency Medical Services (EMS) Week, where hospitals, rescue squads and other organizations around the country recognize the hard work of emergency responders. Many are volunteers and give up free time or even sleep to be there when we need them the most.

He’s a duty officer, meaning he supervises the other volunteers, ensures every EMS call gets a response and fills in wherever he’s needed. He can sleep but wakes up every time a 911 call goes out, or he’s needed for a response, or the phone rings with a question. He gets off at 6:30 a.m. Monday. Then he begins his job as a director of quality assurance and compliance in UVA’s radiology department.

Mondays can be rough. But Hanshew, who began volunteering while he was a UVA student 15 years ago, can’t imagine any other life. At one point, he lived in Northern Virginia and drove to Charlottesville every week for his volunteer shift. A lot of his friends are CARS volunteers, and he says the experience helped him get his job at UVA.

You begin volunteering “because you’re interested in medicine and healthcare, and what sustains you through it, I think, are the personal connections with your crew members, and those long nights you’re pulling through together,” he says.

For Sarah Ferrell, who also began volunteering as a UVA student, CARS became her “surrogate family for an undergrad that was away from home.” She now works in emergency services at UVA and has been volunteering for CARS for seven years.

Both Hanshew and Ferrell are intermediate-level EMTs, which is one step below the highest level, paramedic. This level means they can perform a wide scope of interventions and treatments, and it’s a common level at CARS.

Ferrell, who was the deputy chief of night operations at CARS until December, often volunteered almost forty hours per week in that role. Even though her life now as a UVA employee is far busier, she still runs an average of one shift per week with the agency. The camaraderie with the other volunteers is her favorite part, but the variety of calls and success stories also keep her coming back, such as a cardiac arrest patient in his 30’s.

“We got there, worked with the fire department, resuscitated him, and he walked out a couple of weeks later from the hospital with no deficits,” she says.

EMS at UVA

NETS, the Newborn Emergency Transport System, which transfers babies and children from other hospitals to UVA

Medic-5, a team of 36 EMS providers

Medic-5 handles emergencies near the hospital and transports patients from one facility to another. For example, if someone developed chest pains at Northridge Medical Park, four miles from the hospital, the EMTs would take the person to the hospital. EMTs also transport UVA patients to other facilities, such as nursing homes.

EMS employees can perform different skills based on their level of training, but all are capable of lifesaving interventions such as performing CPR, using an AED or giving oxygen. About half of UVA’s team are paramedics, the highest level EMS provider.

UVA also works with local EMS providers to track UVA patients and review their care from the initial 911 call to the time they’re discharged from the hospital. And when there’s a particularly traumatic incident like a child’s death, UVA works with fire department and rescue squad volunteers who were affected.

UVA’s School of Medicine is part of a unique partnership between the Ministry of Health in the African nation of Rwanda and the U.S. government.

This partnership is facilitated by the Clinton Health Access Initiative (CHAI) run by former President Bill Clinton and includes 13 U.S. schools of medicine, nursing and public health, including UVA.

U.S. faculty will train Rwandese healthcare workers who can then train future generations of doctors, nurses and other health professionals. UVA will provide three to four surgeons and one or two anesthesiologists for the Rwanda Human Resources for Health (HRH) Program.

Robyn Reynolds is a director in the Marketing Department at UVA. She recently volunteered at the Remote Area Medical Clinic (RAM), an annual three-day event in Wise, Va., that offers free medical, dental and vision care.

I have been with the Medical Center for less than a year. During my first week in the Marketing department, I was asked, “Will you go to RAM with us?” I answered “yes” blindly, knowing that I should go. It was just the right thing to do.

I prepared as best I could. Comfortable shoes, twin XL bed sheets, the dreaded fanny pack, extra Keurig cups. But in the end, there’s really no preparing for what happens at RAM. It’s transformative, to say the least.

My partner in Triage was Tom Berry, our director of emergency services. I found this ironic. In the absence of floods, blizzards and construction dilemmas, what happens here really does signal a greater emergency. Most people who come to RAM, constricted by geography and their economic circumstances, get to see a doctor once a year, at best.

They knew the drill; I did not. Arrive early. Take a seat. Try to stay with your family. Speak up for the specialist you’d like to see first. “Dental, orthopedics, mammography. I have this knot on my shoulder.”

It was my job to move people from registration to the nurses’ intake stations. Working outside the clinical environment, I don’t know many nurses. But I knew these caregivers were special. Seasoned nurses, with their commanding and reassuring presences. New nurses, bright-eyed and compassionate beyond their years. All hand-picked for this complex tour of duty.

Sure, I saw things that were unsettling over my three days in Wise, Va., but what I remember most are the things that were reaffirming. I saw Sandra, a model of nursing efficiency, linger with a young woman for close to an hour — at one point, stroking her arm for comfort. I knew what they were talking about had more to do with the patient’s emotional pain than her physical infirmities. I saw Mary with a furrowed brow, concerned, searching her patient’s face for answers, desperate for some hint of what brought him there. I later learned she recommended he be referred to a facility that day for his severe schizophrenia. And I witnessed Sue respectfully greet patients time and time again with unbridled appreciation for simply being able to care for them each muggy morning.

But what I remember most is that this is why I came to UVA. For our singleness of purpose to deliver academic medicine and the acknowledgement that we are privileged to serve those who need us most.

Nearly a week later, I am still tired, my feet sore and my voice coarse, but I am proud. I’ve just begun to process what I saw over those three days, but the skill, compassion and collaboration of my colleagues has left a well-defined and indelible impression. Before joining UVA, I spent 21 years in a business where I wasn’t sure my work made a difference in the grand scheme of things.

UVA’s doctors and nurses care for patients in Charlottesville every day, but their service doesn’t stop in Virginia. Each year, many of our healthcare professionals volunteer to provide free medical care to people in need throughout the world.

Trena Berg, RN, poses with a 4-year-old Bolivian girl who had significant hearing loss. Volunteers gave the little girl a set of ear tubes.

Volunteering in Bolivia

Like many at UVA, Trena Berg, RN, clinical manager in the operating room, has volunteered at the Remote Area Medical Clinic (RAM) in Wise, Va. Last year at RAM, we saw and treated over 1,000 patients in two and a half days for conditions ranging from high blood pressure, diabetes and heart disease to arthritis, depression and pulmonary disease.

But in March, Berg, who’s worked at UVA for 11 years, got the opportunity to use her skills in Bolivia.

She went to Santa Cruz, a city of almost 2 million people, with other volunteers from Mission of Hope, Bolivia, a nonprofit organization based in Charlottesville that provides free medical care to the people of Bolivia, many of whom can’t afford even the most basic care.

“They just don’t have the resources in Bolivia. Even the poorest people here in the United States have more resources than their people have,” Berg says.

“If somebody comes to UVA with a problem, we’re not going to turn them away. In Bolivia, if they can’t pay, they’re not going to get help.”

Mission of Hope is a faith-based organization, and volunteers, who come from all over the United States, go to Santa Cruz for two weeks in the fall and two weeks in the spring each year to perform surgeries. The organization continues to provide other healthcare services in Bolivia throughout the year. Springtime volunteers perform ear, nose and throat surgeries. Volunteers in the fall provide gynecological services and general surgeries.

50 Surgeries in 5 Days

Volunteers set up a fully working hospital for those one-week trips, complete with a kitchen, laundry facilities and two operating rooms. They performed over 50 surgeries in five days. Procedures included rebuilding eardrums, thyroid surgeries and neck gland removal, tonsillectomies and sinus surgeries to remove polyps.

Operating rooms were “no frills,” Berg says, but they were clean and well-equipped, albeit with manual equipment rather than the digital equipment used in this country. The volunteers all brought checked bags full of supplies with them on the plane, including instruments and IV fluids.

An example of the living conditions of many Bolivian patients that medical volunteers treat.

Lyn Wells, MBBS, FRCA, an anesthesiologist at UVA, made her fifth trip to Bolivia in March.

The surgery process for patients starts the night before the procedure, Wells says. Patients are given toiletries so they can wash their hair and brush their teeth. They’re given a bed with clean sheets and a snack. These are things that might not have at home, she says.

And patients aren’t sent home right after their surgery. They usually stay a day or two to recover, Wells says. “We keep them to make sure they’re healing properly. We want to keep the wounds clean and make sure they rest and eat properly.”

Many times, the surgeries are important not just for the patients’ health, but also for their overall well-being, says Berg. People with deformities are shunned in their communities and often have a hard time finding work and supporting their families, she says.

“We’re a little more accepting in the United States of differences in other people.”

Berg got to meet a woman who had a huge tumor removed from her face last year. “She can now work. She came to one of our devotions and it was awesome to see her.”

Rewarding Work

For Berg, the work was gratifying and she saw immediate results, like a woman who had her hearing restored with a prosthesis. “She hugged me and she kissed me. She was so excited. She has 12 children and she could hear them. She was just so grateful to be able to hear them,” Berg says.

Patients come from long distances for their surgeries, many from as much as 8-10 hours away. Patients include native Bolivians and members of the country’s large Mennonite community. Mission of Hope, Bolivia ensures that patients are sent home with grocery money and funds to pay bills during their recovery time.

Berg used personal leave hours for her time away from work. “It was worth it,” she says.

“It was just a very heart-warming experience for me to have people just so appreciate of what you do,” Berg says. “It would be really nice if everyone could have the experience of going and helping others, whether it’s in this country or another country.”

“It’s been a blessing to us to take care of them,” adds Wells.

UVA-Guatemala Initiative

The UVA-Guatemala Initiative (UVA-GI) is a university-wide collaboration started in 2007 by UVA emergency room doctor David R. Burt, MD.

Some participants work in hospitals and clinics in rural parts of Guatemala and are supervised by U.S. and Guatemalan doctors. Others work on community-based research projects on topics like emergency medical systems and water health issues. Recently, faculty and staff participated in faculty development seminars in Guatemala, which is one of the poorest countries in Latin America. More than half of the population lives in poverty, according to the World Health Organization, but it has a rich and diverse culture with many opportunities for partnership, says Burt.

All UVA-GI participants learn to speak Spanish before they go and receive an intensive orientation to the country and its people when they arrive. They’re also encouraged to explore the Guatemalan culture and build relationships with the people of of the country, Burt says.

UVA-GI includes students, residents and faculty from the schools of Medicine, Nursing and Engineering and the university’s College of Arts and Sciences. Burt — who also is a leader for of our RAM efforts — recently won an Excellence in Education Abroad Award from the university for his efforts running the program.

The program has a lasting ripple effect — here and in Guatemala, he says. The new language and cultural lessons are things faculty and students can bring back to the United States and use to provide better care to our patients.

“What better way to learn than to be fully immersed,” Burt says. “It’s a powerful way to build community.”

There’s medical waste like needles and used surgical gloves that needs to be disposed according to strict regulations.

But there’s also other kinds of waste. Unused or outdated supplies. So-called “disposable” items from prepackaged kits, like scissors, gauze and absorbent pads. At many hospitals, these items would end up in a landfill. But because of a program started at UVA in 1992, we send many of these items to good causes in the Charlottesville area and far beyond.

The MERCI Program

Trena Berg, RN, clinical manager in the operating room, has led UVA’s MERCI (Medical Equipment Recovery of Clean Inventory) Program since 2007, when she took over from Helen French, a UVA nurse who founded MERCI. Each Thursday, Berg and volunteers throughout the hospital sort through donated supplies and package them for delivery.

Because of the MERCI Program, many useful items go to organizations like the Charlottesville Albemarle SPCA, the Virginia Wildlife Center and the Charlottesville Pregnancy Center. Supplies are also used by faculty and staff who do research and those who go on medical mission trips around the world.

Helping Charlottesville’s Sister City in Ghana

In 2011, a 40-foot container of medical supplies was shipped by boat to Charlottesville’s sister city, Winneba, in the West African country of Ghana, and a second container was collected for Ghana this past April.

Charlottesville City Councilor Dave Norris and others from the city visited Winneba, Ghana, last year. Norris was Charlottesville’s mayor at the time, and he visited some of the clinics where the supplies were headed.

“These clinics are certainly good candidates for these supplies,” he says. “They’re under-resourced, and they’re serving a lot of people with minimal resources and to be able to have these supplies is really helpful.”

Medical supplies from UVA went to a number of clinics all over Ghana, not just in Winneba, Norris says.

“The healthcare system in Ghana is certainly more advanced than it is in some African countries, but it’s still rudimentary compared to ours.”

Charlottesville’s sister city partnership with Ghana includes much more than medical supplies. Charlottesville leaders and librarians are also lending support to Winneba as it builds its first public library. And there are plans in the works to develop an artist-in-residence program, where artists from Ghana would teach West African art, design and music in Charlottesville city schools. “They have such a rich cultural and artistic tradition there that we could benefit from,” says Norris.

Recyling Medical Supplies at UVA

You might wonder why all these medical supplies aren’t reused at UVA. Don’t we have people who need those supplies in our own clinics and hospital? Actually, much of what MERCI volunteers collect is reused by the Health System, according to Berg.

“Seventy percent of what we get goes back into the system. The hospital is the first priority,” she says. “But the rest we cannot use.”

All medical supplies used at UVA have to be classified as “sterile,” not just “clean,” Berg says. Once products are opened, they are no longer considered sterile. Some products are re-sterilized, but in many cases, U.S. manufacturers won’t stand behind re-sterilized products or the FDA won’t allow those products to be reused, she says.

Berg even saves unused but opened gloves and gowns. Once the gowns are opened, they can’t be used for patient care. But they are used to train medical school students who are learning how to properly put on the gowns and gloves.

There are also cases where labs are disbanded because research projects are completed. Some items may be given to another lab, but we might not have a use for other items, says Berg.

Berg even gets donations from other hospitals and from family members or patients. She often picks up these donations herself.

The MERCI Program recently received a stairlift. Berg kept it in her basement until she could find someone who needed it. She talked to staff at the UVA Kluge Children’s Rehabilitation Center, and they found a family with a brain-damaged little girl who needed the stairlift.

“It’s a lot of networking” to find the right new owners for equipment and supplies, Berg says.

“I don’t believe in us wasting money. As much equipment as I can send back into the system, I do.”

Every July, the UVA volunteers who spend 30 hours providing free healthcare in southwest Virginia leave with many stories, some tragic, some uplifting. Emergency room nurse Tim Cunningham has turned those stories into a powerful one-man play.

Cunningham, according to a University of Virginia story, “conducted intimate, anonymous, one-on-one interviews with more than 30 patients” at the 2009 Remote Area Medical (RAM) clinic in Wise County. He used those interviews to create 11 characters that he portrays in his play, “Out of Their Way.”

I’ve volunteered at RAM for three years and saw Cunningham’s play just before last year’s clinic. It was often poignant, sometimes funny, and I don’t think I was the only one tearing up at the end. This is well worth the 85 minutes out of your day.

A Passion for Nursing

Junior volunteers work in UVA’s gift shop, escort guests to their destinations, deliver flowers and mail and ensure patients are comfortable. They’re required to volunteer weekly, but Alimenti went in twice a week, eventually racking up 350 hours over three summers.

“I absolutely loved it,” she recalls. “I loved being with patients, being able to give back to this hospital that had been keeping my brother alive.”

She realized she enjoyed interacting with patients more than anything.

“I definitely developed this passion for nursing.”

Standout Applicant

UVA Cancer Center volunteer Sara Templeman worked with Alimenti once and was impressed. “Darcy just knew the whole thing,” she says. “She saw what was needed and would take care of it without any direction. She was also very good with the patients, stopping to talk with them.”

Templeman is a member of the Hospital Auxiliary, a group of employees and volunteers. The auxiliary awards its annual Dawson Junior Volunteer Scholarship to an exceptional junior volunteer who has been accepted or is enrolled in a health care degree program.

During the 2009-2010 school year, Alimenti’s senior year at Monticello High School, she was accepted into the UVA School of Nursing and applied for the scholarship.

Her many hours of hospital volunteering stood out, but so did her high grades and contributions to other organizations. Alimenti also volunteered for the American Red Cross and at a local family health provider and helped organize fundraisers for cancer research.

The long list of accomplishments made Alimenti the obvious choice for the $2,500 scholarship.

More surprising, though, is that she got it again in 2011, after continuing her hospital volunteer work and being named to UVA’s Dean’s List.

“It’s certainly unusual to give the scholarship two years in a row, but Darcy really stood out,” Templeman says. “She’s volunteered all over the hospital, practically every area you can think of. She’s done it all cheerfully and with a smile on her face.”

Alimenti now volunteers weekly through Madison House, UVA’s student volunteer organization. She’s currently volunteering in the emergency room, helping patients and their families. That work is more stressful, she says, but she’s never forgotten how it felt to be there with a patient.

Want to Volunteer?

Hospital volunteers can work directly with patients or help behind the scenes. Learn more about the Junior Volunteers program and other volunteer opportunities at the hospital.

Sione Wade’s battle with stage I breast cancer was almost eight years ago and relatively brief. A last-minute appointment enabled her to get a lumpectomy the same week she was diagnosed. She’s been cancer-free ever since.

Sione Wade

But Wade’s never forgotten the phone call from her doctor, the decision about whether to undergo radiation or anything else about her illness. So two years later, she went back to the UVA Breast Care Center, this time as a weekly volunteer.

“I wanted to volunteer here because everybody is so sweet, so kind, so compassionate,” she says. “When I was diagnosed, my husband told me, ‘This experience can either make you bitter or better.’ And I said, ‘Ain’t no way it’s going to make me bitter.’”

Her main job as a volunteer? She puts together kits for newly diagnosed breast cancer patients that include this personal note:

Be encouraged and take one day at a time
Knowing that your strength will come
In moments…
In hours…
In months…
Just at the right time…(more…)

Yesterday, more than 400 Health System employees took a break from their regular jobs to participate in the annual United Way Laurence E. Richardson Day of Caring. We washed dogs, painted school blacktops, did landscaping projects, cleaned animal cages and prepared meals.